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Changes in Body Composition Secondary to Neoadjuvant Chemotherapy for Advanced Esophageal Cancer are Related to the Occurrence of Postoperative Complications After Esophagectomy

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although a survival benefit of neoadjuvant treatment for patients with esophageal cancer has been highlighted, the influence of neoadjuvant treatment on the nutritional status of patients with esophageal cancer is not well understood.

Methods

Changes in body composition parameters were assessed in 30 patients who underwent neoadjuvant chemotherapy (NAC) comprising docetaxel, cisplatin, and 5-fluorouracil followed by esophagectomy from August 2009 to April 2013. Body composition was evaluated before and after NAC using multifrequency bioelectrical impedance analysis (InBody 720; Biospace, Tokyo, Japan). Postoperative complications were graded according to the Clavien-Dindo classification.

Results

Twenty-three postoperative events occurred in 16 patients. A decrease in body protein was observed in 13 patients (43.3 %), while skeletal muscle (SM), body cell mass (BCM), and fat-free mass (FFM) declined in 11 patients (36.7 %) during NAC. Changes in these four parameters during chemotherapy significantly differed between patients with postoperative complications and those without: protein, −1.6 ± 0.9 versus +4.4 ± 2.1 kg (P = 0.01); SM, −1.3 ± 1.1 versus +4.7 ± 2.4 kg (P = 0.02); BCM, −2.4 ± 1.6 versus +3.8 ± 2.2 kg (P = 0.03); and FFM, −1.4 ± 1.4 versus +4.3 ± 2.3 kg (P = 0.04).

Conclusions

Changes in body composition parameters are possible predictive markers of postoperative complications after esophagectomy after NAC. Further analysis is needed to clarify whether nutritional intervention improves such parameters and thus contributes to reduced postoperative morbidity.

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Disclosures

The authors report no financial interests or potential conflicts of interest.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Satoshi Ida MD, PhD, Masayuki Watanabe MD, PhD, FACS, Ryuichi Karashima MD, Yu Imamura MD, PhD, Takatsugu Ishimoto MD, PhD, Yoshifumi Baba MD, PhD, Shiro Iwagami MD, PhD, Yasuo Sakamoto MD, PhD, Yuji Miyamoto MD, PhD, Naoya Yoshida MD, PhD, FACS & Hideo Baba MD, PhD, FACS

Authors
  1. Satoshi Ida MD, PhD
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  2. Masayuki Watanabe MD, PhD, FACS
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  3. Ryuichi Karashima MD
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  4. Yu Imamura MD, PhD
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  5. Takatsugu Ishimoto MD, PhD
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  6. Yoshifumi Baba MD, PhD
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  7. Shiro Iwagami MD, PhD
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  8. Yasuo Sakamoto MD, PhD
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  9. Yuji Miyamoto MD, PhD
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  10. Naoya Yoshida MD, PhD, FACS
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  11. Hideo Baba MD, PhD, FACS
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Corresponding author

Correspondence to Hideo Baba MD, PhD, FACS.

Electronic supplementary material

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Supplementary Fig. S1

Changes in nutritional parameters during NAC. a Body weight, b body mass index, c fat mass, d total body water, and e mineral content (EPS 1047 kb)

Supplementary Fig. S2

Correlation between body composition changes and the occurrence of postoperative complications. a Decrease in body weight (Δbody weight), b Δbody mass index, c Δfat mass, d Δtotal body water, and e Δmineral (EPS 87.9 kb)

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Ida, S., Watanabe, M., Karashima, R. et al. Changes in Body Composition Secondary to Neoadjuvant Chemotherapy for Advanced Esophageal Cancer are Related to the Occurrence of Postoperative Complications After Esophagectomy. Ann Surg Oncol 21, 3675–3679 (2014). https://doi.org/10.1245/s10434-014-3737-z

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  • DOI: https://doi.org/10.1245/s10434-014-3737-z

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